JMIR Publications

ABSTRACT

Background:

Interventions are required that address delays in treatment seeking and low treatment coverage amongst people who consume methamphetamine.

Objective:

This study sought to determine whether a self-administered smartphone-based intervention, the “S-Check App” can increase help seeking and motivation to change methamphetamine use, and determine factors associated with app engagement.

Methods:

Intervention: Randomised, 28-day wait-list controlled trial. Consenting adults residing in Australia who reported using MA at least once in the last month were eligible to download the app free-of-charge from Android™/iOS® app stores. Those randomised to the intervention group had immediate access to the S-Check App, the control group were wait-listed for 28 days before gaining access, all then had access until Day 56. Outcomes and analyses: Actual help seeking and intention to seek help were assessed by the modified Actual Help Seeking Questionnaire (mAHSQ), and the modified General Help Seeking Questionnaire (mGHSQ), motivation to change methamphetamine use by the modified Readiness Ruler (mRR). Chi-square comparisons of the proportion of positive responses to the mAHSQ, mGHSQ and mRR were conducted between the two groups. Logistic regression models compared the odds of actual help seeking, intention to seek help, and motivation to change at Day 28 between the two groups. Secondary outcomes were: most commonly accessed features of the app, methamphetamine use, feasibility and acceptability of the app, and associations between S-Check App engagement and participant demographic and methamphetamine use characteristics.

Results:

Five-hundred and sixty participants downloaded the app; 259 (46%) completed eConsent and baseline; and 84 (32%) provided data at Day 28. Participants in the immediate access group were more likely to seek professional help (mAHSQ) at Day 28 than those in the control group (45.5% vs 23.5%, X(1)=4.42, P=.036). There was no significant difference in the odds of actual help seeking, intention to seek help or motivation to change methamphetamine use between the two groups on the primary logistic regression analyses, while in ancillary analyses with imputed dataset there was a significant difference in the odds of seeking professional help between participants in the immediate access group compared to the waitlist control group (adjusted odds ratio 2.64, 95% Confidence Interval 1.19 – 5.83, P=.017). For participants not seeking help at Baseline, each minute in the app increased the likelihood of seeking professional help by Day 28 by 8% (ratio 1.08, 95% CI 1.02 – 1.22, P=.040). Amongst the intervention group, a 10-minute increase in app engagement time was associated with a decrease in days of methamphetamine use by 0.4 days (regression coefficient [β] -0.04, P=.020).

Conclusions:

The S-Check App is a feasible, low resource self-administered intervention for adults in Australia who consume methamphetamine. Study attrition was high, and while common in mobile health interventions, warrants larger studies of the S-Check App. Clinical Trial: ANZCTR: ACTRN12619000534189